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Lesson IV - Abnormalities in the ECG Measurements IV. Abnormalities in the ECG Measurements Frank G. Yanowitz, MD Professor of Medicine University of Utah School of Medicine Click on the measurement abnormality you would like to study 1. Heart Rate 2. PR Interval 3. QRS Duration 4. QT Interval 5. QRS Axis 1. Heart Rate In normal sinus rhythm, a resting heart rate of below 60 bpm is called bradycardia and a rate of above 90 bpm is called tachycardia. 2. PR Interval (measured from beginning of P to beginning of QRS in the frontal plane) Normal: 0.12 - 0.20s Short PR:
Lesson IV - Abnormalities in the ECG Measurements (called the "Kent" bundle) connects the right atrium to the right ventricle (see diagram below) or the left atrium to the left ventricle, and this permits early activation of the ventricles (delta wave) and a short PR interval. Click to view LGL (Lown-Ganong-Levine): An AV nodal bypass track into the His bundle exists, and this permits early activation of the ventricles without a delta-wave because the ventricular activation sequence is normal. AV Junctional Rhythms with retrograde atrial activation (inverted P waves in II, III, aVF): Retrograde P waves may occur before the QRS complex (usually with a short PR interval), in the QRS complex (i.e., hidden from view), or after the QRS complex (i.e., in the ST segment). Ectopic atrial rhythms originating near the AV node (the PR interval is short because atrial activation originates close to the AV node; the P wave morphology is different from the sinus P) Normal variant Prolonged PR: >0.20s First degree AV block (PR interval usually constant) Intra-atrial conduction delay (uncommon) Slowed conduction in AV node (most common site) Slowed conduction in His bundle (rare) Slowed conduction in bundle branch (when contralateral bundle is blocked) http://library.med.utah.edu/kw/ecg/ecg_outline/Lesson4/index.html (2 of 5) [5/11/2006 9:39:37 AM]
Page 1 and 2: ECG Learning Center Dr. Alan Lindsa
Page 3 and 4: ECG Introduction sublime to the rid
Page 5 and 6: ECG Image Index ECG Image Index ECG
Page 7 and 8: ECG Image Index ecg_446.gif--Wander
Page 9 and 10: ECG Image Index 6. Ventricular Rhyt
Page 11 and 12: ECG Image Index ecg_0327.gif--Ventr
Page 13 and 14: ECG Image Index 13. Odds & Ends ecg
Page 15 and 16: ECG Introduction ACC/AHA Clinical C
Page 17 and 18: ECG Introduction ● ● ● ● Le
Page 19 and 20: ECG Feedback The Alan E. Linday ECG
Page 21 and 22: Lesson III - Characteristics of the
Page 27 and 28: Lesson 1: The Standard 12 Lead ECG
Page 29 and 30: Lesson 1: The Standard 12 Lead ECG
Page 31 and 32: Lesson II - A "Method of ECG Interp
Page 33: Lesson II - A "Method of ECG Interp
Page 37 and 38: Lesson IV - Abnormalities in the EC
Page 39 and 40: Lesson V - ECG Rhythm Abnormalities
Page 41 and 42: Lesson VI - ECG Conduction Abnormal
Page 53 and 54: Lesson VII - Atrial Enlargement wav
Page 55 and 56: Lesson VIII - Ventricular Hypertrop
Page 57 and 58: Lesson VIII - Ventricular Hypertrop
Page 59 and 60: Lesson IX - Myocardial Infarction I
Page 61 and 62: Lesson IX - Myocardial Infarction I
Page 63 and 64: Lesson IX - Myocardial Infarction c
Page 65 and 66: Lesson IX - Myocardial Infarction c
Page 67 and 68: Lesson IX - Myocardial Infarction "
Page 69 and 70: Lesson X - ST Segment Abnormalities
Page 75 and 76: Lesson XI - T Wave Abnormalities cl
Page 77 and 78: Lesson XII - Nice Seeing "U" Again
Page 79 and 80: Lesson V (cont) - ECG Rhythm Abnorm
Page 81 and 82: Lesson V (cont) - ECG Rhythm Abnorm
Page 83 and 84: Lesson V - ECG Rhythm Abnormalities
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Lesson V - ECG Rhythm Abnormalities
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Lesson V (cont)- Ventricular Arrhyt
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Lesson II (cont): Determining the Q
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ecg_ac.html 60 Cycle Artifact - Mar
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ecg_tremor.html Muscle Tremor Artif
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ecg_arrhythmia.html Marked Sinus Ar
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ecg_0374_mod.html Sino-Atrial Exit
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ecg_403.html Not All Sore Thumbs Ar
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ecg_491.html Atrial Tachycardia Wit
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ecg_vent_pace.html Ventricular Paci
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ecg_12lead008.html Atrial Flutter W
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ecg_12lead009z.html Atrial Flutter
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ecg_478.html Atrial Flutter With 2:
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ecg_12lead011.html Atrial Flutter W
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ecg_junctional.html Junctional Esca
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ecg_500.html Junctional Tachycardia
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ecg_494.html Digitalis Intoxication
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ecg_0280_mod.html 1st Degree AV Blo
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ecg_0311_mod.html How long can the
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ecg_0283_mod.html A Very Subtle 1st
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http://library.med.utah.edu/kw/ecg/
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ecg_12lead020.html Left Atrial Enla
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ecg_12lead030.html Inferior MI: Ful
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ecg_486.html Giant TU Fusion Waves-
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ecg_517.html WPW Diagram-KH Frank G
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ecg_703.html Conceptual Framework:
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ecg_compens.html Compensatory vs. N
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ecg_conduct.html RV vs LV PVC's - M
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ecg_evol.html Diagram: Stages of Ac
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ecg_lindsay.html Alan E. Lindsay, M
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ecg_outline39.html The Three Fates
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ecg_outline42.html Frank G. Yanowit
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ecg_outlline12.html Diagram: Fronta
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ecg_torso.html Frontal and Horizont
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ecg_560.html QRS Axis = -30 degrees
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ecg_562.html Left Axis Deviation: Q
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ecg_564.html QRS Axis = +30 degrees
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ecg_565.html Left Axis Deviation: Q
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ecg_6lead001.html Frontal Plane QRS
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ecg_6lead013.html Indeterminate Fro
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ecg_6lead017.html Left Axis Deviati
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ecg_446.html Wandering Atrial Pacem
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ecg_normal.html Normal Sinus Rhythm
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ecg_wander.html Wandering Atrial Pa
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ecg_0226_mod2.html What are those f
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ecg_0229_mod.html Left Ventricular
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ecg_0273_mod.html Ventricular Paras
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ecg_0277_mod.html PVC With Venticul
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ecg_0315_mod.html Nonconducted And
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ecg_402.html Identification of PVC'
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ecg_410.html An Interpolated PAC-KH
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ecg_418.html A Nonconducted PAC Cau
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ecg_441.html Atrial Parasystole-KH
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ecg_457.html Nonconducted and Aberr
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ecg_485.html Junctional Parasystole
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ecg_aberrant.html PAC's With and Wi
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ecg_bigeminy.html Atrial Bigeminy -
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ecg_inter_pvc.html Interpolated PVC
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ecg_paired.html PAC Couplet - Marqu
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ecg_ront.html PVC with R-on-T - Mar
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ecg_trigem_pvc.html PVCs - Marquett
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ecg_v_fusion.html Ventricular Fusio
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ecg_12lead069.html Atrial Fibrillat
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ecg_487.html Atrial tachycardia Wit
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ecg_498.html A Very Subtle Atrial T
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ecg_505.html Atrial Tachycardia Wit
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ecg_6lead016.html Atrial Flutter wi
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ecg_atrial_tachy.html Atrial Tachyc
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ecg_0325_mod.html Accelerated Ventr
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ecg_12lead057.html Left Ventricular
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ecg_12lead063.html Right Ventricula
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ecg_escape.html Ventricular Escape
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ecg_v_asyst.html Ventricular Asysto
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ecg_0236_mod.html AV Dissociation b
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ecg_0246_mod.html Isochronic Ventri
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ecg_0287_mod.html 2nd Degree AV Blo
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ecg_0293_mod.html Trifascicular Blo
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ecg_0295_mod.html Mobitz II 2nd Deg
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ecg_0298_mod.html 2nd Degree AV Blo
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ecg_0301_mod.html Complete AV Block
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ecg_0312_mod.html ECG Of The Centur
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ecg_411.html Atrial Echos-KH Frank
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ecg_480.html Second Degree AV Block
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ecg_507.html 2nd Degree AV Block Wi
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ecg_second_av1.html 2nd Degree AV B
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ecg_12lead012.html Left Anterior Fa
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ecg_12lead013.html Left Bundle Bran
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ecg_12lead014.html RBBB With Primar
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ecg_12lead015.html Bifascicular Blo
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ecg_12lead016z.html RBBB: Precordia
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ecg_12lead018z.html WPW Type Preexc
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ecg_12lead034z.html Infero-posterio
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ecg_12lead036.html Inferior & Anter
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ecg_12lead043.html Atypical LBBB wi
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ecg_12lead046.html Infero-posterior
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ecg_12lead049.html RBBB + LAFB: Bif
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ecg_12lead068.html WPW and Pseudo-i
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ecg_476.html Rate-dependent LBBB-KH
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ecg_706.html Left Anterior Fasicula
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ecg_first_av1.html Right Bundle Bra
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ecg_preexcite.html WPW Type Preexci
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ecg_0327_mod.html Ventricular Paced
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ecg_12lead045z.html Ventricular Pac
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ecg_12lead065.html Atrial Pacemaker
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ecg_12lead067.html AV Sequential Pa
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ecg_av_pace.html AV Sequential Pace
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ecg_paced.html Pacemaker Fusion Bea
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ecg_spikes.html Electronic Ventricu
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ecg_12lead026z.html Anteroseptal MI
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ecg_12lead027z.html Extensive Anter
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ecg_12lead029.html Infero-posterior
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ecg_12lead031.html Acute Inferopost
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ecg_12lead032z.html Postero-lateral
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ecg_12lead037.html Acute Inferopost
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ecg_12lead038.html Old Infero-poste
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ecg_12lead040.html Old Inferior MI,
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ecg_711.html Frontal Plane: Acceler
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ecg_721.html Inferoposterior MI-KH
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ecg_12lead020z.html Left Atrial Enl
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ecg_12lead021z.html Right Axis Devi
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ecg_12lead022z.html RAE & RVH-KH Fr
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ecg_12lead025.html LVH and Many PVC
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ecg_12lead042.html LVH: Limb Lead C
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ecg_12lead048.html RVH with Right A
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ecg_12lead054.html LVH - Best seen
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ecg_705.html http://library.med.uta
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ecg_12lead002.html Long QT Interval
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ecg_12lead003z.html Long QT Interva
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ecg_12lead004z.html Normal Variant:
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ecg_12lead007.html Inferolateral ST
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ecg_12lead056.html Long QT: An ECG
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ecg_12lead061.html Advanced Hyperka
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ecg_12lead001.html Lead Error: V1 &
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ecg_calibration.html Calibration Si
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